Carlos Daniel Chico-Mendez, MD
Individual provider Active NPI General Practice Physician · Hatillo, PR
NPI 1881719953 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1881719953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 10461 (PR)
- Practice address
- Ave. Doctor Francisco Susoni # 112
Hatillo, PR 00659 - Phone
- (787) 898-4689
- Fax
- (787) 898-4689
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081105000383 | PR | Practitioner - General Practice |
6002975067 | Practice locations: Hatillo, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10461 | PR | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 10461 | PR | Yes |
Addresses
Primary practice location
Ave. Doctor Francisco Susoni # 112
Hatillo, PR 00659
Mailing address
HC 6 Box 61277
Camuy, PR 00627-9010
Phone (787) 898-4689
Other providers in Hatillo, PR
- Centro Pediatrico de Hatillo CSP
- Centro Psicologico Ekilibrio CSP
- Centro Radiologico CDT Dr Ferdinando Maldonado
- Melissa Chaves
- Adrian Rafael Chico Moya
- Citizen Medical Services Corp
- Donna Marie Clement
- Clinica Dental Bayaney CSP
- Clinica Dental Borges, C.S.P.
- Clinica Familiar Dr Edwin Olmeda CSP
All providers in Hatillo, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.